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长期食用非发酵和发酵乳制品与雌激素受体状态的乳腺癌风险 - 基于人群的前瞻性队列研究。

Long-term consumption of non-fermented and fermented dairy products and risk of breast cancer by estrogen receptor status - Population-based prospective cohort study.

机构信息

Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Nutrition Research Laboratory, Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland.

Department of Health and Welfare Science, Faculty of Sport Science, Sendai University, Japan.

出版信息

Clin Nutr. 2021 Apr;40(4):1966-1973. doi: 10.1016/j.clnu.2020.09.013. Epub 2020 Sep 17.

Abstract

BACKGROUND & AIMS: The impact of dairy consumption on breast cancer development is unclear. We sought to examine associations between long-term consumption of milk and fermented dairy products and risk of breast cancer by estrogen (ER) and progesterone receptor (PR) status and assess whether these associations varied by body weight.

METHODS

The population-based Swedish Mammography Cohort included 33,780 women (88.2% postmenopausal), with no history of cancer or diabetes at baseline (1997). Long-term consumption of dairy products was assessed using a self-administered food-frequency questionnaire in 1987 and 1997. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

During 16.6 years of follow-up (559,286 person-years), 1870 total breast cancer cases were diagnosed (1162 ER+/PR+; 195 ER-/PR-). High long-term non-fermented milk consumption was associated with increased ER+/PR+ breast cancer incidence, HR = 1.30, 95%CI:1.02-1.65 for the average of 1987 and 1997 intake ≥2 vs. 0 servings/day and this increased risk was limited to women with BMI<25 kg/m HR = 1.55, 95%CI:1.08-2.21, while no significant associations with milk consumption were observed with ER-/PR- breast cancer. In contrast, consumption of fermented dairy products was inversely associated with ER-/PR- breast cancer (for consistently high intake ≥3 vs. <1 servings/day HR = 0.28, 95%CI:0.10-0.78), but not clear association was observed for ER+/PR+ (HR = 0.89, 95%CI:0.69-1.14).

CONCLUSIONS

In this cohort of mainly postmenopausal women, high long-term consumption of milk was associated with increased risk of ER+/PR+ breast cancer. In contrast, high long-term consumption of fermented dairy products was associated with decreased risk of ER-/PR- breast cancer.

摘要

背景与目的

乳制品的摄入对乳腺癌发展的影响尚不清楚。我们旨在通过雌激素(ER)和孕激素受体(PR)状态来研究长期摄入牛奶和发酵乳制品与乳腺癌风险之间的关联,并评估这些关联是否因体重而异。

方法

基于人群的瑞典乳腺队列纳入了 33780 名女性(88.2%绝经后),基线时无癌症或糖尿病史(1997 年)。乳制品的长期摄入量通过 1987 年和 1997 年的自我管理食物频率问卷进行评估。使用 Cox 比例风险回归模型估计风险比(HR)和 95%置信区间(CI)。

结果

在 16.6 年的随访期间(559286 人年),诊断出 1870 例乳腺癌(1162 例 ER+/PR+;195 例 ER-/PR-)。长期大量摄入非发酵牛奶与 ER+/PR+乳腺癌发病率升高相关,HR=1.30(1987 年和 1997 年摄入量≥2 份/天与 0 份/天的平均值 95%CI:1.02-1.65),且这种风险增加仅限于 BMI<25kg/m 的女性,HR=1.55(95%CI:1.08-2.21),而与 ER-/PR-乳腺癌无明显关联。相反,发酵乳制品的摄入与 ER-/PR-乳腺癌呈负相关(持续高摄入量≥3 份/天与<1 份/天 HR=0.28(95%CI:0.10-0.78)),但对 ER+/PR+未见明显关联(HR=0.89(95%CI:0.69-1.14))。

结论

在这项主要为绝经后女性的队列研究中,长期大量摄入牛奶与 ER+/PR+乳腺癌风险增加有关。相反,长期大量摄入发酵乳制品与 ER-/PR-乳腺癌风险降低有关。

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